Acute ischemic stroke: a rare complication of hump-nosed pit viper (Hypnale spp.) bite: a case report

Hump-nosed pit viper is a medically important deadly venomous snake in Sri Lanka and is the commonest cause of venomous snakebites in the country. It frequently causes local effects and systemic manifestations such as acute kidney injury and coagulopathy that occur in less than 10% of all bites. Thi...

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Bibliographic Details
Published in:Journal of medical case reports 2022-06, Vol.16 (1), p.218-218, Article 218
Main Authors: Namal Rathnayaka, R M M K, Nishanthi Ranathunga, P E A, Kularatne, S A M, Jayasinghe, Sanath
Format: Article
Language:English
Subjects:
Biological products
Bites and stings
Cardiac arrhythmia
Care and treatment
Case Report
Case reports
Clopidogrel
Creatinine
Electrocardiography
Enzymes
Glasgow Coma Scale
Heart attack
Heart attacks
Heart rate
Hemoglobin
Hump-nosed pit viper
Hypnale
Ischemia
Ischemic stroke
Kidneys
Laboratories
Neurotoxicity
Physical therapy
Poisonous snakes
Purpura
Sinhalese
Snake bites
Snakebites
Snakes
Speech therapy
Sri Lanka
Stroke
Thrombocytopenia
Venom
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Summary:Hump-nosed pit viper is a medically important deadly venomous snake in Sri Lanka and is the commonest cause of venomous snakebites in the country. It frequently causes local effects and systemic manifestations such as acute kidney injury and coagulopathy that occur in less than 10% of all bites. This also includes some atypical presentations such as thrombotic microangiopathy and myocardial infarction. Currently, no antivenom is available for hump-nosed pit viper bites in Sri Lanka, and patients are managed with supportive treatment. This case illustrates an acute ischemic stroke following a hump-nosed viper bite, which is the second case in the literature. A 71-year-old a Sinhalese male patient presented with left-sided hemiparesis with mouth deviation on day 2 of hump-nosed viper (Hypnale spp.) bite on the right foot. Non-contrast computed tomography of brain showed right ischemic stroke in internal capsule. He was given antiplatelets and statins and continued supportive treatment including limb physiotherapy and speech therapy. He recovered completely and was discharged on day 4 with clinic follow-up. Physicians should be aware that ischemic cerebral infarcts may occur following hump-nosed pit viper bites.
ISSN:1752-1947
1752-1947
DOI:10.1186/s13256-022-03442-3